Researchers Develop Automated System to Improve Children’s Health

Researchers from Indiana University and the Indianapolis-based Regenstrief Institute have developed an automated system aimed at helping enable pediatricians focus on the specific health needs of each patient in the short time allotted for preventive care. The systems comes on the heels of a new study, “Automated Primary Care Screening in Pediatric Waiting Rooms,” in the May 2012 issue of Pediatrics which found personalizing and automating the patient screening process and then alerting the physician to positive results of risk factors enables them to direct attention to the particular needs of the individual child and the child’s family.

The automated system created by the Indiana University and Regenstrief researchers, called the Child Health Improvement through Computer Automation System (CHICA), aims to do exactly that.

“Research has shown that what is recommended for well-child pediatric visits greatly exceeds what is practical to accomplish,” senior study author Stephen Downs, M.D., IU School of Medicine associate professor of pediatrics and a Regenstrief Institute investigator, said in a statement. “CHICA prescreens so the physician can focus on what needs to be done for each individual child. The computer picks 20 questions to be answered by the family based on what’s known about that family — for e example someone living in the household smokes or the child has previously been diagnosed with asthma.”

The system uses information from a child's parent or other family member in the waiting room as well as pre-existing data from the Regenstrief Medical Record System, the nation's oldest continually operational electronic medical record system, to provide critical information and clinical reminders to pediatricians. The personal-based information comes when family members use a pencil and paper to answer targeted questions. Responses are scanned into the electronic medical record before the pediatrician sees the child.

For instance, if the parent has indicated that the child lives with a smoker, CHICA will prompt the pediatrician to discuss smoking cessation programs as well as dangers of second-hand smoke.

An open-source system, CHICA, the researchers say, can interface with any electronic medical record system. It aims to solve questions of both information overload and costs while helping the pediatrician focus on the specifics of the patient in the examination room, according to the study authors.

“In our study of nearly 17,000 patients, over 408,000 questions were asked and we had an impressive response rate of 89 percent,”study first author Vibha Anand, Ph.D., IU School of Medicine assistant professor of pediatrics and a Regenstrief Institute affiliated scientist, said in a statement. “One in 10 answers indicated a risk factor, so on average CHICA identified two areas needing targeted physician focus per clinic visit for each child.”

The study was conducted in pediatric clinics at Wishard Health Services, a large public health care system in Indianapolis. It was funded by the National Institutes of Health.

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